Permit II,
CITY OF TIGARD
MECHANICAL PERMIT
iA DEVELOPMENT SERVICES PERMIT #: MEC2005 -00598
' 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 10/4/2005
PARCEL: 1S12600-00300
SITE ADDRESS: 09306 SW WASHINGTON SQUARE RD ZONING: C -G
SUBDIVISION: WASHINGTON SQUARE LOT: JURISDICTION: TIG
Project Description: T.I. Valuation: $8,000.
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: COM UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: M VENTS W/O APPL: VENT SYSTEMS:
STORIES: BOILERS /COMPRESSORS HOODS:
FUEL TYPES 0 - 3 HP: 1 DOMES. INCIN:
ELE 3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP: REPAIR UNITS:
FIRE DAMPERS ?: 30 - 50 HP: WOODSTOVES:
GAS PRESSURE: 50 + HP: CLO DRYERS:
FURN < 100K BTU: AIR HANDLING UNITS OTHER UNITS:
FURN > =100K BTU: < =10000 cfm: GAS OUTLETS:
> 10000 cfm:
Owner: FEES
WASHINGTON SQUARE LLC Description Date Amount
BY THE MACERICH COMPANY [MECH] Permit Fee 10/3/200E $195.50
9585 SW WASHINGTON SQUARE RD [MECPLN] Plan Rev 10/3/200; $48.88
TIGARD, OR 97223 [TAX] 8% State Surchar€ 10/3/200° $15.64
Phone: Total $260.02
Contractor:
SKY HEATING + AIR CONDITIONING
1635 SE NEHALEM REQUIRED ITEMS AND REPORTS
PORTLAND, OR 97202
Phone: 503 235 - 9083
Reg #: LIC 50244
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. Specialty Codes and
all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not
started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires
you to follow rules adopted in the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010
through OAR 952 -001 -0100. You may obtain copies of these rules or direct questions to OUNC by calling 503 - 246 -6699
or1- 800 -33 = _.
Issued : 1 it iWl Permittee Signature
Call 503 - 639 -4175 by 7:00 a.m. for inspections business day.
This permit cans shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
I
Mechanical Permit o s4 ,l �1 ,§ FOIZ �r FIC ► USE ONLY �. � i,• � { s _.. Received
City of Tigard Date/B - Permit No
y m m 06 A ,
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
Phone: 503.639.4171 Fax: 503.59501) 21 2005 */n = l ; , Date/By 1 ' y 't�Si Other P ermit
Inspecti Line: 503.639.4175 11 i t l Date Ready/By ®See Page 2 for
Internet: www.ci.tigard.or.us TIG Notified/Method. Supplemental Information
CITY OF
BUI19/ O ON
COMMERCIAL • FEE . SCHEDULE =' USE CHECKLIST
Mechanical permit fees* are based on the value of the work
❑ New construction ❑ Addition/alteration/replacement
performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition a Other: Tlaniar i,.,T - °J4irsE,A.r'r mechanical materials, equipment, labor, overhead, and profit.
CATEGORY OF CONSTRUCTION Value: $ 8, p 60 .
RESIDENTIAL EQUIPMENT / SYSTEMS'FEES *. '
❑ 1 and 2 family dwelling aTommercial/industrial ❑ Accessory building
For special information use checklist.
❑ Multi ❑ Master builder ❑ Other:
Description I Qty I Ea. I Total
' . ' cys06 , JOB SITE INFORMATION AND LOCATION-,' ' , Heating/cooling
Job site address: Si (, ) d , 362 vy,� �. + 4n Air conditioning or heat pump
(requires site plan showing placement) 14.00
City /State /ZIP: ( , 1 ,4, 4. 0 t p 4.., 97 2Z3 Furnace 100,000 BTU ( ducts/vents) 14.00
D Furnace 100,000+ BTU (ducts/vents) 17.90
Suite/bldg. /apt. no.: Project name. M %_ Gas heat pump 14.00
Cross street /directions to job site: Duct work 14.00
Hydronic hot water system 14.00
' (.)4 St--1 as Co f■■) S U.■ M.4J itilA.LA . Residential boiler (radiator or
hydronic) 14.00
Unit heaters (fuel -type, not electric),
in -wall, to -duct, suspended, etc. 10.00
Subdivision Lot no.:
Flue /vent for any of above 10.00
Other: 10.00
Tax map /parcel no: Other fuel appliances
DESCRIPTION OF WORK Water heater 10.00
Gas fireplace 10.00
A AI' of f4 p., . 7 .: Ts..., re. AFL ..) Flue vent for water heater or gas
" . Sr R `..... t� EO q L l igh 10.00
/ Vt. Log lighter (gas) 10.00
h/j ,t>,, l _ jf yS"TR Wood/pellet stove 10.00
GG DD �� Wood fireplace /insert 10 00
' ` .. ❑ PROPERTY OWNER ` 1 A TENANT ' Chimney /liner /flue/vent 10 00 I
Other: 10.00
Name: c-- MA AS S4g Environmental exhaust and ventilation
4 Range hood/other kitchen
Address: equipment 10.00
City /State/ZIP: Clothes dryer exhaust 10.00
Single -duct exhaust (bathrooms,
Phone: ( ) Fax: ( ) toilet compartments, utility rooms) 6.80
APPLICANT CONTACT PERSON - Attic/crawlspace fans 10 00
Other. 10.00
Business name./ Sr 41 D-s. OT CArt . Fuel piping
Contact name "F tRAu a�
V C rvs LOT $5.40 for first four; $1.00 for each additional
Address: ( Furnace, etc.
T11 rr , Z A S lgQr"atub W * 4 7 Gas heat pump
City /State /ZIP: - 104,T �� lio �� /9 6 +u Zsia 1 Wall /suspended/unit heater
Z Water heater
Phone: (515.3 ) etc) • e s- i7 F ax:: (ts83) 2,ze. • S.51
r,, Fireplace
E FRO,abK• Sc.fi n.1 Cr @.7h.A,,1.0 sc.4r. adT' - L.err+ Range
CONTRACTOR _ Barbecue
c�(y 1 � /j w . (iD _ Clothes dryer (gas)
Business name. Qj� ��' / C.. Li f
Other.
Address: MECHANICAL PERMIT FEES* -
City /State /ZIP: Subtotal
Minimum permit fee ($72.50) I 9,s�
Phone. ( ) Fax ( ) Plan review (25% of permit f e e ) y 8 . f . 1 _
CCB lic.. State surcharge (8% of permit fee) f j f `1
// TOTAL PERMIT FEE •60,'0
Authorized signature: •� ' This p ermit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Print name: •1K riti1. Date: 7 . Z) . pS"' • Fee methodology set by Tri- County Building Industry Service Board
I \ Building \Permits\MEC- PcimiiApp doc 11/03 440- 46I7T(1I /02/COM/WEB) %
Mechanical Permit Application - City of Tigard ' ∎,
Page 2 - Supplemental Information
Commercial Fee Schedule:
"Total, Valuation': Permit`Fee: •
$1.00 to $2,000.00 Minimum fee $72.50
$2,001.00 to $5,000.00 $72.50 for the first $2,000.00 and $2.30
for each additional $100.00 or fraction
• thereof, to and including $5,000.00. ' .
$5,001.00 to $10;000:00 $141.50 for the first $5,000.00 and
$1.80 for each additional $100.00 or
fraction thereof, to and including
$10,000.00.
$10,001.00 to $50,000.00 $231.50 for the first $10,000.00 and •$1.35 for each additional $100.00 or r „ - ,
fraction thereof, to and including
$50,000.00.
$50,001.00 to $100,000.00 $771.50 for the first $50,000.0U : and : , . , $1.25 for each additional $100.00 or
fraction thereof, to and including r /� }1 n _
$100,000.00. F C (J / •. r ' /� ( �
$100,000.01 and up $1,396.50 for the first $100,000.00 and 17_
$1.10 for each additional $100.00 or
fraction thereof.
Note: All new commercial buildings require 2 sets of plans.
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i:\Building\Permits\MEC- PermitApp doc 12/03 • 2 •